New oncology patients at BC Children’s Hospital, an agency of the Provincial Health Services Authority, now receive state-of-the-art testing for genetic variations that increase the risk of serious complications from two common chemotherapy drugs. With the results of this testing, each child’s care team can develop a personalized treatment plan that balances the risks of side effects with the therapeutic benefits of these life-saving drugs.

“We’re very pleased to treat the 150th patient through this innovative program” says Dr. Bruce Carleton, the Director of the Pharmaceutical Outcomes Programme at BC Children’s Hospital and a Professor in the Department of Pediatrics at the University of British Columbia. “Genomic testing allows us to create an individual genetic risk assessment for every patient that helps doctors and families make more informed decisions about treatment.”

The Personalized Medicine Programme tests pediatric cancer patients for genetic variations that increase the risk of serious side effects from two life-saving chemotherapy drugs: cisplatin and anthracyclines. Cisplatin is frequently used to treat children with leukemia, brain, bone and liver cancers. It can cause permanent hearing loss in some patients. Anthracyclines treat leukemia, bone tumors and other cancers, but can lead to heart damage that may result in heart failure and the need for a heart transplant. Children are at particular risk for these complications and live with the effects for the rest of their lives.

An individual’s risk of suffering side effects for these drugs varies greatly based on genetics. For example, the risk of heart damage from anythracylines is between 14 per cent and 89 per cent depending on a person’s genetics.

“If we find a child is more likely to develop complications, we can consider modifying treatment so he or she receives the life-saving benefits of these drugs while minimizing risk,” says Dr. Rod Rassekh an Investigator and Oncologist at BC Children’s Hospital and a Clinical Assistant Professor in the Department of Pediatrics at the University of British Columbia. “We also carefully monitor children in the high-risk group for complications, both during treatment and years afterwards. For families of children at lower risk of side effects, the testing provides reassurance during a difficult time.”

Dr. Carleton, Dr. Rassekh and their colleagues are working to expand the testing program at BC Children’s Hospital to hospitals across Canada and patient groups beyond oncology. They are currently collaborating with clinicians and researchers at hospitals in Calgary, Winnipeg, Toronto, London, Montreal and Ottawa on the groundwork and logistics necessary to offer testing at treatment centres in those cities.

“These are life-saving drugs,” says Dr. Carleton, “but sometimes they cause harm. Genomic testing is a powerful tool to help children who have to take these medications live the longest, healthiest lives possible.”

Funding
This research is supported by BC Children’s Hospital Foundation. The Personalized Medicine Programme is funded by the Provincial Health Services Authority and Genome BC.